- |||||||||| sevoflurane / Generic mfg.
Neuronal Substrates of Rapid Eye Movement Sleep Rebound After Sevoflurane (Upper 9) - Jun 20, 2021 - Abstract #ASA2021ASA_2459;
We found hypo-activity of the vlPAG REMS-suppressing neurons, and activation of the SLD REMS-generating neurons, in rodents displaying REMS rebound after SEVO. Our findings are consistent with existing literature implicating the vlPAG and SLD brain regions in the control of REMS and with the notion that a REMS debt accrues in rodents anesthetized with SEVO.A mechanistic understanding of the neuronal substrates involved in sleep and anesthesia will provide a rationale for selecting agents with a more favorable sleep profile to reduce morbidity and mortality associated with postoperative sleep disturbances.
- |||||||||| sevoflurane / Generic mfg.
[VIRTUAL] Greening The Operating Room (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_2406;
As less than 5% of delivered anesthetic gas is metabolized by the patient, the great majority will be vented to the atmosphere.[3] Desflurane in particular is an exceptionally potent GHG and has an increased "lifetime" in the atmosphere, 10 years compared to 1.2 years for sevoflurane...We are, after all, only as healthy as the environment we inhabit. [1] https://practicegreenhealth.org/topics/climate-and-health/mitigation[2] https://practicegreenhealth.org/topics/greening-operating-room/greening-or[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173371/[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173371/
- |||||||||| High-Risk Transvenous Lead Extractions (Mezzanine 16AB) - Jun 20, 2021 - Abstract #ASA2021ASA_2300;
Her outpatient medications were metformin, amlodipine, aspirin and furosemide...General anesthesia is maintained with sevoflurane/oxygen mixture...What is "ghost"? and what is the significance of its presence for the patient?
- |||||||||| midazolam hydrochloride / Generic mfg.
The Leadless Pacemaker, Treat It Like Any Pacemaker? (Mezzanine 16AB) - Jun 20, 2021 - Abstract #ASA2021ASA_2168;
After tracheal intubation with a double-lumen tube, general anesthesia was maintained with sevoflurane at a MAC level of 0.8...The surgery took place without complication, ondansetron was administered and the patient was extubated after emergence without issues...The surgical team plans for an emergent re-exploration for presumed bleeding. What is your plan for management of this CIED in an emergent scenario?
- |||||||||| ondansetron / Generic mfg., sevoflurane / Generic mfg., methadone / Generic mfg.
How to Disclose a Medical Error and Becoming a Second Victim: What Should I Do? (Mezzanine 16AB) - Jun 20, 2021 - Abstract #ASA2021ASA_2022;
The patient has been on methadone for about 1 year with fair control of the back pain.The mother reports that the patient just finished antibiotics due to recovering from an episode of mild sinusitis...You plan a general anesthetic using sevoflurane and a tracheal tube.It appears that the mother looked up your board certification profile before you entered the room...You told the mother that you will give the generic version, ondansetron, to her daughter during the procedure and will reevaluate the need for home dosing after the procedure has been completed.4...Over time, you have taken the advice of your leader and have read many articles about Second Victims. You now feel that you're not alone and that this is a normal response.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., sevoflurane / Generic mfg.
[VIRTUAL] Reduced Postoperative Pain In Patients Receiving Nociception Monitor Guided Analgesia During Elective Surgery (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_2002;
We attribute this to more timely, objective and personalized fentanyl dosing based on improved tritation of opioids to individual patient's response to nociceptive stimuli during anesthesia resulting in beneficial effects on pain experience. This study confirms the results of a previous pilot study conducted by Meijer et al., and further demonstrates that the benefits of NOL-Guided analgesia titration may be achieved independently of depth of anesthesia monitoring which may increase its adoption in routine clinical practice.
- |||||||||| [VIRTUAL] Temperature Agreement During Anesthesia Between Neck With Zero-heat-flux Thermometry And Esophageal (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_1832;
General anesthesia was induced by propofol (1.5-2.0 mg/kg), fentanyl (1.0-2.0 μg/kg), and rocuronium (0.9 mg/kg) and the tracheal intubation was performed...Anesthesia was maintained with 1.5% sevoflurane or 4.5% desflurane, and 0.1-0.2 μg/kg/min remifentanil... This study revealed the agreement between neck and esophageal temperature, suggesting that neck is also a reliable site for measuring core temperature during general anesthesia.
- |||||||||| sevoflurane / Generic mfg.
[VIRTUAL] Effects Of Different Concentrations Of Sevoflurane On Respiratory Inflammation In Juvenile Asthmatic Rats (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_1808;
Different concentrations of sevoflurane had dual effects on the developing respiratory system with asthma, which is that low concentration of sevoflurane aggravates respiratory inflammation and has nociceptive effect; high concentration of sevoflurane could reduce respiratory inflammation and has protective effect. The results suggested that in the anesthesia of pediatric surgery, high concentration of sevoflurane is beneficial to the airway of children with asthma, but children with asthma should be avoid from exposure to low concentration of sevoflurane.
- |||||||||| Chronogesic (sufentanil) / Durect
[VIRTUAL] Anesthetic Consideration For SEEG Placement (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_1691;
Retrospective analyses show that patients recover well, requiring minimal time in the ICU. There is low risk of inducing seizures during placement as only 3 patients required rescue AEDs.
- |||||||||| sevoflurane / Generic mfg.
[VIRTUAL] Dopaminergic (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_1591;
Figure 1.VTA-DA activity and neural dynamics in response to sevoflurane. Figure 2.Optogenetic activation of VTA-DA neurons facilitates arousal from sevoflurane anesthesia.
- |||||||||| midazolam hydrochloride / Generic mfg.
The Leadless Pacemaker, Treat It Like Any Pacemaker? (Mezzanine 16AB) - Jun 20, 2021 - Abstract #ASA2021ASA_1431;
After tracheal intubation with a double-lumen tube, general anesthesia was maintained with sevoflurane at a MAC level of 0.8...The surgery took place without complication, ondansetron was administered and the patient was extubated after emergence without issues...The surgical team plans for an emergent re-exploration for presumed bleeding. What is your plan for management of this CIED in an emergent scenario?
- |||||||||| Is My Patient Suitable for Ambulatory Outpatient Surgery? How to Balance Morbid Obesity, Obstructive Sleep Apnea, Diabetes, and Opiates in the Ambulatory Surgical Patient (Mezzanine 16AB) - Jun 20, 2021 - Abstract #ASA2021ASA_1303;
Her current medications include oxycodone, 5 mg 4 time a day as needed, lisinopril, 10 mg at bedtime, gliburide, 10 mg once per day, NPH insulin, 40 units subcutaneously at bedtime, and regular insulin, as needed on a sliding scale for blood glucose greater than 200 mg/dL...You discuss your plans for general anesthesia with the patient, and plan premedication with gabapentin, acetaminophen, and a scopolamine patch.What general anesthetic technique would you plan for this patient?Why?...Additionally, you titrate fentanyl, 100 mcg, and 0.5mg hydromorphone and maintain the patient on sevoflurane for the surgery which takes one hour...What pain medications should she be instructed to avoid? Why?
- |||||||||| Is My Patient Suitable for Ambulatory Outpatient Surgery? How to Balance Morbid Obesity, Obstructive Sleep Apnea, Diabetes, and Opiates in the Ambulatory Surgical Patient (Mezzanine 16AB) - Jun 20, 2021 - Abstract #ASA2021ASA_1299;
Her current medications include oxycodone, 5 mg 4 time a day as needed, lisinopril, 10 mg at bedtime, gliburide, 10 mg once per day, NPH insulin, 40 units subcutaneously at bedtime, and regular insulin, as needed on a sliding scale for blood glucose greater than 200 mg/dL...You discuss your plans for general anesthesia with the patient, and plan premedication with gabapentin, acetaminophen, and a scopolamine patch.What general anesthetic technique would you plan for this patient?Why?...Additionally, you titrate fentanyl, 100 mcg, and 0.5mg hydromorphone and maintain the patient on sevoflurane for the surgery which takes one hour...What pain medications should she be instructed to avoid? Why?
- |||||||||| sevoflurane / Generic mfg.
CF21. Is This Malignant Hyperthermia (MH)? (Upper 11AB) - Jun 20, 2021 - Abstract #ASA2021ASA_825;
Variable penetrance and aborted cases common with use of current volatile agents (i.e., sevoflurane, and desflurane) have had a significant impact in delayed diagnosis and treatment of an MH crisis, resulting in a rise in mortality from MH...Appraise the difficulties in diagnosis and treatment of aborted MH cases. Differentiate and formulate management of common hypermetabolic disorders.
- |||||||||| ondansetron / Generic mfg., sevoflurane / Generic mfg., methadone / Generic mfg.
How to Disclose a Medical Error and Becoming a Second Victim: What Should I Do? (Mezzanine 16AB) - Jun 20, 2021 - Abstract #ASA2021ASA_792;
The patient has been on methadone for about 1 year with fair control of the back pain.The mother reports that the patient just finished antibiotics due to recovering from an episode of mild sinusitis...You plan a general anesthetic using sevoflurane and a tracheal tube.It appears that the mother looked up your board certification profile before you entered the room...You told the mother that you will give the generic version, ondansetron, to her daughter during the procedure and will reevaluate the need for home dosing after the procedure has been completed.4...Over time, you have taken the advice of your leader and have read many articles about Second Victims. You now feel that you're not alone and that this is a normal response.
- |||||||||| ByFavo (remimazolam) / PAION, Cosmo Pharma, Mundipharma, Pharmascience, Acacia Pharma
[VIRTUAL] Effect Of Remimazolam On Angiotensin Ii-induced Vasoconstriction (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_783;
The metabolites of remimazolam are inactive and remimazolam does not cause rebound sedation, which is a problem with midazolam, and it does not cause vascular pain, which is a drawback of propofol...MethodsMale Wistar rats weighing 200-300 g were anesthetized with sevoflurane and killed by decapitation...ConclusionOur results demonstrated that remimazolam did not inhibit Ang II-induced vasoconstriction. As one of the mechanisms that remimazolam stabilizes hemodynamics, it is considered that remimazolam may preserve the vascular tone maintained by Ang II.
- |||||||||| sevoflurane / Generic mfg.
[VIRTUAL] Propofol And Sevoflurane Have Opposite Effects On Oncogenic Signaling Networks During Colon Cancer Surgery (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_782;
The combined analysis of EV-related miRNAs and their cellular mRNA targets revealed inhibitory as well as activating mechanisms involved in tumor progression and metastasis of both agents, but was limited to CC cells and did not include other immuneregulatory effects of anesthetic agents which could influence tumor outcome. 1.Int J Physiol Pathophysiol Pharmacol 2019; 11: 83-942.Anesthesiology 2020; 133: 764-7733.Front Cell Dev Biol 2018; 6: 184.Anesthesiology 2020; 132: 107-1205.BMC Cancer 2008; 8: 3206.Human Cell 2019; 32: 31-40
- |||||||||| ketamine / Generic mfg.
[VIRTUAL] Total Intravenous Versus Inhalational Anaesthesia For Fibreoptic Bronchoscope Guided Nasotracheal Intubation In Children (Virtual) - Jun 20, 2021 - Abstract #ASA2021ASA_4;
The findings are in line with our experience using the same method in adult patients. Since awake intubation is not practical in children, propofol combined with ketamine (ketofol) has the potential to be a substitute for inhalational anaesthesia in such situations...Sevoflurane was used for induction through facemask followed by sevoflurane through a nasopharyngeal airway for maintenance of anaesthesia in the inhalational group...Ketofol infusion with supplemental propofol boluses provide satisfactory intubating conditions with similar rates of success and adverse events when compared to inhalational anaesthesia to perform nasal fibreoptic intubation in children.
- |||||||||| sevoflurane / Generic mfg.
Preclinical, Journal: Neonatal Exposure to Anesthesia Leads to Cognitive Deficits in Old Age: Prevention with Intranasal Administration of Insulin in Mice. (Pubmed Central) - Jun 16, 2021
Here, we report that repeated exposures of neonatal mice (P7-9 days old) to anesthesia with sevoflurane (3 h/day for 3 days) led to cognitive impairment that was detectable at the age of 18-19 months, as assessed by using novel object recognition, Morris water maze, and fear conditioning tests...These results suggest that neonatal exposure to general anesthesia could increase the risk for cognitive impairment during aging. This study also supports pre-treatment with intranasal administration of insulin to be a simple, effective approach to prevent infants and children from the increased risk for age-related cognitive impairment induced by neonatal exposure to general anesthesia.
- |||||||||| sevoflurane / Generic mfg.
Journal: Comparative study of recovery of airway reflexes and cognitive function following sevoflurane versus desflurane anaesthesia. (Pubmed Central) - Jun 10, 2021
Patients receiving desflurane showed faster response to verbal commands (5.93 ± 4.13 vs. 8.20 ± 3.39 min, P value = 0.024), passed the swallowing test earlier (10.03 ± 4.97 vs. 13.70 ± 3.48 min, P value = 0.009) and Short orientation memory concentration test (SOMCT) earlier (9.83 ± 4.51 vs. 14.10 ± 4.31 min, P value ≤0.001) compared to sevoflurane. In patients undergoing laparoscopic cholecystectomy under controlled conditions, earlier recovery is seen with desflurane compared to sevoflurane.
- |||||||||| sevoflurane / Generic mfg.
Journal: lncRNAs Are Involved in Sevoflurane Anesthesia-Related Brain Function Modulation through Affecting Mitochondrial Function and Aging Process. (Pubmed Central) - Jun 9, 2021
Functional annotation and differentially expressed- (DE-) lncRNA-mRNA coexpression networks reveal that DE-lncRNAs are associated with mitochondrial dysfunction and oxidative stress, aging-related metabolism alterations, DNA damage, and apoptosis, as well as neurodegenerative features during sevoflurane anesthesia. These results suggest that lncRNAs play roles in general anesthesia-related brain function modulation during the perioperative context and provide insights into the lncRNA-related modulation mechanisms and targets.
- |||||||||| heparin sodium injection / Generic mfg., sevoflurane / Generic mfg.
Clinical, Journal: Methylenetetrahydrofolate Reductase Deficiency: A Case Report. (Pubmed Central) - Jun 8, 2021
Propofol and sevoflurane do not increase homocysteine levels and are considered safe for patients with MTHFR deficiency. This case study describes a 58-year-old man with known MTHFR deficiency and his subsequent uneventful anesthetic care during a total knee replacement.
- |||||||||| sevoflurane / Generic mfg.
Clinical, Journal: Supraglottic Airway Devices for Elective Pediatric Anesthesia: I-gel versus Air-Q, Which is the Best? (Pubmed Central) - Jun 8, 2021
All patients were anesthetized by sevoflurane inhalation using a face mask without neuromuscular blockade...However, I-gel SAD required a shorter insertion time and provided a high SR which is satisfactory for trainees and during an emergency. I-gel SAD allowed minimization of tidal volume leak and gastric inflation and is associated with infrequent complications.
- |||||||||| sevoflurane / Generic mfg.
Journal: Monitoring the level of hypnosis using a hierarchical SVM system. (Pubmed Central) - Jun 5, 2021
This paper proposes a novel automated method for accurate assessing of the level of hypnosis with sevoflurane in 17 patients using the electroencephalogram signal...Then deep state is identified by extracting the sample entropy feature; and finally light and general states are identified by extracting the three mentioned features of the first step. The accuracy of the proposed method of analyzing the brain activity during anesthesia is 94.11%; which was better than previous studies and also a commercial monitoring system (Response Entropy Index).
- |||||||||| sevoflurane / Generic mfg.
Clinical, Journal: Ephedrine and phenylephrine induce opposite changes in cerebral and paraspinal tissue oxygen saturation, measured with near-infrared spectroscopy: a randomized controlled trial. (Pubmed Central) - Jun 5, 2021
A randomized 4-treatment cross-over trial was designed in 28 patients under BIS-titrated anaesthesia with sevoflurane...In contrast, compared to PE, E was associated with a significant decrease in rSO at T-T, T-T and L-L (- 2.0%, 95% CI [- 2.8, - 1.1], p < 0.001; - 1.4%, 95% CI [- 2.4%, - 0.4%], p = 0.006; and - 1.5%, 95% CI [- 2.3%, - 0.8%], p < 0.001, respectively). An opposite effect on rSO and rSO was observed after bolus administration of PE and E.
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